In this extra post, Lynsey encourages us to pause and critically reflect on how we engage with our routine e-learning modules with an engaging fire safety example. Lynsey Downie is an Anaesthesia Associate based in Edinburgh and a recent graduate of the MSc Clinical Education programme↗️.
On a bitterly cold November morning, a continuous fire alarm sounded in the outpatient clinic I was working in that day. As is usually the case, a moment of disbelief passed, followed by the realisation that the alarm wasn’t a test – we actually have to respond appropriately. In theory, this shouldn’t be an issue – the NHS relies heavily on online teaching to provide staff with the knowledge and skills required to fulfil their roles. This online learning is delivered via a digital platform, with each member of staff having a set number of mandatory courses which must be completed at set intervals (once only, annually, two yearly) in order to demonstrate ongoing competence, including fire safety. Staff, including myself, dutifully complete these modules when reminded to, via automatic emailing systems, or worse – a reminder by their line manager that modules are expired. Line managers are usually prompted by their senior, highlighting data reporting that particular percentage of “compliance”. The lower the compliance, the more serious the tone of the reminder to staff.
We are all guilty of scanning quickly through modules to the assessment. Who has time to go through this stuff? Get this box ticked for your boss and that’s another year sorted. I have worked for the NHS for 16 years, passed the online module year after year, added it to my appraisal certificate and awaited the annual “module expired” reminder. I must again prove I have the knowledge required to respond appropriately to a fire alarm and keep patients safe…or at least prove that I can pass the module.
In this context, motivation to learn is dissolved and simply replaced by an extrinsic motivation just to pass and move on. Deep, transformational learning is not the goal. Fawns, Aitken and Jones (2021)↗️ highlight that “datafication” of education in healthcare creates a culture of performativity rather than accountability and efficiency. That day, two months ago when the fire alarm was sounding, this was never so obvious. Although I was working with staff who have undoubtedly passed the fire safety module many times, there was an absolute uncertainty of how to act.
We must consider what truly reflects success in terms of workplace digital education – both at an organisational and individual level – otherwise we will continue to see the “DATA REPORT – REMIND – CRAM” response and our measurement of success will remain skewed.
As demonstrated that day during the fire drill, a successful pass does not reflect practice – or allow us to practice reflection.
I am regularly reminded of that winter day as the weekly 10am fire alarm test echoes along the corridors and consultation rooms. Staff, patients and visitors alike pause conversations; learning that there is no point in trying to raise our voices over the loud alarm tone. Through my own reflection on the actions of the team that day last November, I have learned to use these pauses as an opportunity to reflect – to consider what action I would take if this was the real thing, in order to protect my colleagues and patients. I maintain my knowledge through my eLearning; not because I have to in order to keep management happy but so I am not frozen in a state of unconscious incompetence (Roland and Matheson, 2012↗️) – caught out when I have to put learning into practice.
The ability to reflect has been associated with higher levels of learning in a number of taxonomies – from Bloom to Moon and beyond. It allows us to learn from experience and, crucially, take ownership of our learning. Instead of seeing the fire drill and e-learning modules as a box that must be ticked to satisfy management, perhaps we could all use the momentary pause as a reminder that, one day, we may have to practice in the real world that which we currently only cram to pass online.
References
Fawns, T., Aitken, G., Jones, D. (2021). Online Postgraduate Education in a Postdigital World Beyond Technology: Beyond Technology↗️. 10.1007/978-3-030-77673-2.
Roland, D. and Matheson, D. (2012). New theory from an old technique: the Rolma matrices↗️.The Clinical Teacher, 9(3), pp.143–147. doi:https://doi.org/10.1111/j.1743-498x.2011.00520.x.
Lynsey Downie
I am an Anaesthesia Associate based in Edinburgh and a recent graduate of the MSc Clinical Education programme↗️ (University of Edinburgh). As Education Lead for AA training in the East Region, I enjoy facilitating the learning of AA trainees as well as all learners within the clinical environment. I am enthusiastic about promoting staff development and learning within the NHS and plan to utilise the knowledge and skills gained through participation in the MSc Clinical Education to cultivate this.
With thanks to Dr Kirstin Stuart James for supporting and encouraging me to submit to Teaching Matters and the wider MSc Clinical Education team for their support during my studies.